Nokea
The nurse is interviewing a 38-week gestation Muslim woman.
- A. Do you plan to breastfeed your baby?
- B. What do you plan to name the baby?
- C. Which pediatrician do you plan to use?
- D. How do you feel about having an episiotomy?
Correct Answer: D
Rationale: Questions about episiotomy might be culturally sensitive or inappropriate without prior discussion of preferences, especially in certain cultural contexts like Islam.
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A pregnant patient at 24 weeks gestation reports feeling fatigued and lightheaded. What is the nurse's first priority action?
- A. Encourage the patient to rest and drink fluids.
- B. Monitor the patient's blood pressure and assess for signs of anemia.
- C. Administer iron supplements to alleviate fatigue.
- D. Instruct the patient to avoid any physical activity until symptoms subside.
Correct Answer: B
Rationale: The correct answer is B. Monitoring the patient's blood pressure and assessing for signs of anemia is the first priority because fatigue and lightheadedness in pregnancy can be symptoms of anemia or other serious conditions. Anemia can lead to complications for both the mother and the baby. Encouraging rest and fluids (choice A) is important but should come after ruling out any potential serious conditions. Administering iron supplements (choice C) without proper assessment can be harmful if anemia is not the cause. Instructing the patient to avoid physical activity (choice D) without proper evaluation can delay necessary interventions.
During a preconception counseling session, the nurse encourages a couple to prepare a birth plan.
- A. Promote communication between the couple and health care professionals.
- B. Enable the couple to learn about the types of pain medicine used in labor.
- C. Provide the couple with a list of items that they should take to the hospital for the labor and delivery.
- D. Give the high-risk couple a sense of control over the likelihood of having a surgical delivery.
Correct Answer: A
Rationale: A birth plan fosters open communication between the couple and healthcare providers, ensuring that expectations and preferences are understood.
A nurse is assisting with a vaginal birth and is monitoring for the risk of umbilical cord prolapse. Which is the most appropriate intervention if the cord is prolapsed?
- A. place the person in the knee-chest position
- B. reposition the laboring person
- C. administer oxygen via mask
- D. apply pressure to the cord
Correct Answer: A
Rationale: The correct answer is A: place the person in the knee-chest position. Placing the person in this position helps alleviate pressure on the umbilical cord, reducing the risk of compression and improving fetal oxygenation. Other choices like repositioning the laboring person or administering oxygen via mask do not directly address the issue of cord prolapse. Applying pressure to the cord can further compromise blood flow to the fetus. The knee-chest position is the most appropriate intervention as it helps relieve pressure on the cord and is crucial in managing umbilical cord prolapse effectively.
The nurse is taking a history of a mother who admits to cocaine drug use. Which action should the nurse take first?
- A. Refer the patient to a drug abuse program.
- B. Screen the infant for side effects associated with cocaine use.
- C. Educate the patient of the risks associated with cocaine use during pregnancy.
- D. Advise the patient that her baby will be okay even with the history of cocaine use.
Correct Answer: C
Rationale: The correct action for the nurse to take first is to educate the patient of the risks associated with cocaine use during pregnancy (Choice C). This is important because it helps the mother understand the potential harm that cocaine can cause to both her and her baby. By providing education, the nurse can empower the mother to make informed decisions for the health and well-being of herself and her baby. Referring the patient to a drug abuse program (Choice A) may be necessary but not the immediate first step. Screening the infant for side effects (Choice B) should be done later after educating the mother. Advising the patient that her baby will be okay (Choice D) is not appropriate as it downplays the seriousness of cocaine use during pregnancy.
A patient at 36 weeks gestation is undergoing a nonstress test (NST). The nurse observes the fetal heart rate baseline at 135 bpm and four nonepisodic patterns of the fetal heart rate reaching 160 bpm for 20-25 seconds each. How will the nurse record these findings?
- A. NST positive, nonreassuring
- B. NST negative, reassuring
- C. NST reactive, reassuring
- D. NST nonreactive, nonreassuring
Correct Answer: C
Rationale: An NST is reactive and reassuring when two or more accelerations occur within 20 minutes, indicating fetal well-being.